I am seldom surprised by our poll findings, but this month’s tracking poll produced a doozy. Twenty-two percent of the American people think the Affordable Care Act has been repealed, and another 26 percent aren’t sure. Those are surprisingly large numbers even with the 52 percent who still know it is the law of the land.

How could a repeal “vote” in the House — however dramatic but still, only symbolic — be misunderstood as an actual repeal by so many Americans?First, people are very busy just getting through the day and they don’t have a lot of time to sort through news reports about the policymaking process. They see the word “repeal” in the local paper or hear it on TV and think the law has been repealed. Second, there may be some partisan wishful thinking going on; 30 percent of Republicans think the law has been repealed while only 12 percent of Democrats do. But overall, it is obvious that the knowledge of basic civics is pretty low. Maybe it’s because “Schoolhouse Rock” is no longer airing on Saturday morning TV explaining how government works.

(Coincidentally, a district court judge in Florida ruled at about the same time that the individual requirement to buy insurance in the health reform law is unconstitutional. One other district judge has ruled similarly on the individual requirement, while two others have now upheld the law at the time of our survey. The legal questions are a long way from being settled. We did not ask the public whether they believe the law has been overturned in the courts and is now void.)

People who follow politics every day know that the U.S. Senate and the President will block any attempts to repeal the health law, and that the legal process will take a long and winding road to a conclusion. But they were not the audience for the House repeal vote. Opponents of the health law succeeded in capturing public attention with the repeal vote, just as they did during the town hall meetings in the summer of 2009 when the terms “government takeover” and “death panels” rose to prominence.

With the repeal vote behind them, congressional Republicans face some choices. Do they continue their assault, pushing for repeal and defunding? This would appeal to their political base and sow doubt about the law but probably not achieve big changes in the legislation or win over many new voters for 2012. (Remember, while those of us in health policy live the issue day-to-day, health has almost never been a voting issue). Or, do they aim for smaller changes to the law, potentially with some crossover Democratic votes?

Health reform proponents face strategic and tactical decisions as well. Do they engage in a continuing war on health reform by responding forcefully to Republican attacks on the law, touting its popular benefits but keeping the assault on health reform in the news? Or, are they better off changing the subject to more central public concerns such as jobs and the economy, allowing implementation to proceed in a less confrontational environment?

No matter how this plays out, we might need a new installment of “Schoolhouse Rock” to explain the legislative process a little better to the public. As a part time pollster I should not be too surprised by these results, but as someone who once taught a course called “The Policymaking Process” in a political science department at a major university, it is a little jarring to learn that almost half the American people do not know the difference between a symbolic repeal vote in the House and the actual repeal of the law.